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Case study

Transforming hospital capacity management: Experience from two academic medical centres

Erin Kane, Kimiyoshi Kobayashi, Peter F. Dunn and James J. Scheulen
Management in Healthcare: A Peer-Reviewed Journal, 3 (4), 339-348 (2019)
https://doi.org/10.69554/MGTW4971

Abstract

Historically, capacity has been ‘undermanaged’ in health systems. Traditional mechanisms that rely on single departments to solve these problems are inadequate. New governance and managerial mechanisms are needed for redesigning care at the hospital and health system level. On the basis of our collective experience at two large academic medical centres, we identified four important elements of effective capacity management: a dedicated leadership role with a hospital-level view, centralised analytics defining universal metrics, aligned incentives across the institution and an engaged front-line staff. This paper shares case studies from two different academic medical centres, highlighting tools developed to manage patient flow and streamline operations while operating at high capacity.

Keywords: capacity management; Command Center; patient flow; throughput; systems engineering

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Author's Biography

Erin Kane MD, is an emergency physician and assistant professor at the George Washington University School of Medicine and Health Sciences. She previously served as the Assistant Medical Director for the Johns Hopkins Office of Capacity Optimization and the Johns Hopkins Capacity Command Center. Dr Kane received her undergraduate and medical degrees from Harvard University. She is board certified in emergency medicine and completed her training in the Johns Hopkins Emergency Medicine Residency Program, where she served as Chief Resident. Dr Kane was also a senior associate in the office of McKinsey & Company in Washington, DC, where she served a range of hospital, health system and payer clients in the public and private sectors. Her current work focuses on hospital process redesign, patient-centred operations and the delivery of high-value healthcare.

Kimiyoshi Kobayashi MD, MBA, is a hospitalist at the Johns Hopkins Hospital. He works as a physician leader in the Johns Hopkins Capacity Command Center. He was previously at Massachusetts General Hospital, where he was the Director for Inpatient Medicine for the Department of Medicine, responsible for the operations of the inpatient medical services. Dr Kobayashi was also the Physician Director for eCare/Epic within the Office of the Chief Medical Officer. He is board certified in internal medicine and completed his internal medicine residency at Massachusetts General Hospital. He earned his medical degree from Johns Hopkins University School of Medicine and his master of business administration from Harvard Business School.

Peter F. Dunn MD, is Vice President, Perioperative Services and Healthcare Systems Engineering, at Massachusetts General Hospital (MGH), in Boston, MA. He co-leads all aspects of perioperative operations with the associate chief nurse for perioperative services. Earlier, Dr Dunn was Clinical Director of the Department of Anesthesia, Critical Care and Pain Medicine (DACCPM), and served as Executive Vice Chair of DACCPM. He received his undergraduate and medical degrees in the Early Selection Program at the George Washington University. He pursued initial postgraduate training in surgery at George Washington University and basic science research at the National Institutes of Health. Dr Dunn joined MGH in 1995, where he received his training in both anesthesia and critical care. More recently, along with colleagues from the MIT Sloan School of Management, Dr Dunn and his team at MGH are developing tools and methodologies to redesign the provision of patient care. Dr Dunn is Assistant Professor of Anesthesia at Harvard Medical School and Program Director of the Perioperative Administration Fellowship at MGH.

James J. Scheulen MBA, PA, is Chief Administrative Officer, Emergency Medicine and Capacity Management for Johns Hopkins Medicine. He is responsible for the operations of the five Johns Hopkins Health System Emergency Departments, which together manage nearly 300,000 patient visits per year. Mr Scheulen is considered to be an expert in hospital and emergency department operations and is a leader in applying systems engineering concepts to healthcare management. He is the founder and director of the Hopkins Access Line and Johns Hopkins Lifeline critical care transportation service and, as Chief Administrative Officer, leads efforts to manage hospital capacity for Johns Hopkins. In this role, he leads institutional efforts at process improvement and has operationalised a one-of-a kind hospital capacity optimisation command centre. Mr Scheulen is active in the leadership of pre-hospital emergency medical services and emergency preparedness for Hopkins and the State of Maryland.

Citation

Kane, Erin, Kobayashi, Kimiyoshi, Dunn, Peter F. and Scheulen, James J. (2019, March 1). Transforming hospital capacity management: Experience from two academic medical centres. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 3, Issue 4. https://doi.org/10.69554/MGTW4971.

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cover image, Management in Healthcare: A Peer-Reviewed Journal
Management in Healthcare: A Peer-Reviewed Journal
Volume 3 / Issue 4
© Henry Stewart
Publications LLP

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